An open label parallel design randomized control trial of type 2 diabetes management with two-meals a day and exercise against the conventional multi-meal and exercise approach for effect on HbA1c and anti-diabetic medication in six months in newly detected diabetic subjects in a tertiary care Institute in Maharashtra.

Type 2 Diabetes is the rapidly growing non communicable disease in India, with preponement of age of commencement and early organ damage. The world needs ways to prevent Type 2 Diabetes epidemic and rollback of the disease. However, the rising prevalence of Type 2 Diabetes is evidence that both lifestyle and clinical management are facing challenges.

Conventional management of T2DM banks on small frequent meals, moderate exercise, and anti-diabetic medication (ADM). Many patients are now following a 2-meal a day frequency and moderate exercise (2OMEX) lifestyle with medication adjustments due to a popular campaign in Maharashtra, with a reported decline in HbA1c and even remission of Type 2 Diabetes. The recommendations strongly suggest that newly diagnosed diabetic subjects should receive a fair trial with lifestyle modification before initiating oral hypoglycaemic medication. Currently, various lifestyle modifications are popular including vegan diets, small diets for calorie restriction, intermittent fasting, and all with moderate daily/ weekly /5 days workouts.

The present study aims to test this hypothesis of Type 2 Diabetes control and remission in 2OMEX and conventional management arm, the main difference being frequency of meals (2 meals only or more than 2 meals as daily routine), while moderate exercise of 45 minutes (4.5 km walk) being common to both arms. We want to do this as an open label randomized clinical study, in a tertiary institute setting,  OPD subjects detected recently with uncomplicated T2D with HbA1c between 7-10 gm% and on, none or two or less oral anti-diabetic medication molecules.